Doxorubicin (DOX) is a cornerstone chemotherapeutic agent
for the treatment of several malignancies such as breast cancer; however,
its activity is ameliorated by the development of a resistant phenotype. Phyllanthus species have been studied previously
for their potential anticancer properties. The current work is aimed
to study the potential cytotoxicity and chemomodulatory effects of
hypophyllanthin (PN4) and phyllanthin (PN5) isolated from Phyllanthus niruri to DOX against the adriamycin multidrug-resistant breast cancer
cells (MCF-7ADR) and elucidate their mechanism of action.
The major compounds of the active methylene chloride fraction were
isolated and assessed for their potential cytotoxicity and chemomodulatory
effects on DOX against naïve (MCF-7) and resistant breast (MCF-7ADR) cancer cells. The mechanism of action of both compounds
in terms of their impacts on programmed/non-programmed cell death
(apoptosis and autophagy/necrosis), cell cycle progression/arrest,
and tumor cell migration/invasion was investigated. Both compounds PN4 and PN5 showed a moderate but similar potency
against MCF-7 as well as MCF-7ADR and significantly synergized
DOX-induced anticancer properties against MCF-7ADR. The
chemomodulatory effect of both compounds to DOX was found to be via
potentiating DOX-induced cell cycle interference and apoptosis induction.
It was found that PN4 and PN5 blocked the
apoptosis-escape autophagy pathway in MCF-7ADR. On the
molecular level, both compounds interfered with SIRT1 expression and
consequently suppressed Akt phosphorylation, and PN5 blocked
apoptosis escape. Furthermore, PN4 and PN5 showed promising antimigratory and anti-invasive effects against
MCF-7ADR, as confirmed by suppression of N-cadherin/β-catenin
expression. In conclusion, for the first time, hypophyllanthin and
phyllanthin isolated from P. niruri showed promising chemomodulatory effects to the DOX-induced chemotherapeutic
activity against MCF-7ADR. Both compounds significantly
synergized DOX-induced anticancer properties against MCF-7ADR. This enhanced activity was explained by further promoting DOX-induced
apoptosis and suppressing the apoptosis-escape autophagy feature of
the resistant breast cancer cells. Both compounds (hypophyllanthin
and phyllanthin) interfered with the SIRT1/Akt pathway and suppressed
the N-cadherin/β-catenin axis, confirming the observed antiproliferative,
cytotoxic, and anti-invasive effects of hypophyllanthin and phyllanthin.